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Foods many people choose to limit include: Fried foods Heavy, creamy meals Sugary snacks and desserts Carbonated beverages Alcohol These foods can slow digestion further and increase nausea or discomfort

doi:10.1111/cts.13109

All authors reviewed and revised the manuscript

Common Symptoms May Include: Persistent fatigue or weakness Brain fog or difficulty concentrating Rapid heartbeat Shortness of breath with exertion Mood changes Numbness or tingling (advanced cases) Individuals at Higher Risk: Vegetarians and vegans Patients with celiac disease or other malabsorption disorders Those taking acid-reducing medications (PPIs, H2 blockers) Long-term oral contraceptive users Individuals with heavy alcohol use Patients with pernicious anemia Individuals with chronic gastrointestinal conditions Deficiency can negatively impact metabolism, neurologic function, and immune health if left unaddressed

During tirzepatide treatment initiation, patients benefit from preventive conversations with their prescriber about pain history, medication allergies, and preferred pain relief strategies

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